BACKGROUND AND AIMS: The prevalence of sexual dysfunctions in people with diabetes is still debated and understudied in women. This study examines the prevalence of sexual dysfunction in men and women with type 1 or type 2 diabetes (T1D or T2D) and the associations with clinical and psychological variables. METHODS: Adults with diabetes (n=756) completed an online survey including questions on sexual functioning (adapted Short Sexual Functional Scale), general emotional well-being (WHO-5), symptoms of anxiety (GAD-7) and diabetes distress (PAID-20). RESULTS: One third of participants reported a sexual dysfunction. Men reported erectile dysfunction (T1D:20%; T2D: 33%), and orgasmic dysfunction (T1D:22%; T2D:27%). In men, sexual dysfunction was independently associated with, older age (OR=1.05, p=0.022), higher waist circumference (OR=1.04; p<0.001) and longer duration of diabetes (OR=1.04; p=0.007). More men with sexual dysfunction reported diabetes distress (20% vs. 12%, p=0.026). Women reported decreased desire (T1D:22%; T2D:15%) and decreased arousal (T1D:9%; T2D:11%). More women with sexual dysfunction reported diabetes distress (36% vs. 21%, p=0.003), impaired emotional well-being (36% vs. 25%, p=0.036) and anxiety symptoms (20% vs. 11%, p=0.026). CONCLUSION: Sexual dysfunctions are common in both men and women with diabetes. In men, sexual dysfunctions were associated with clinical factors. More women with sexual dysfunction reported low emotional well-being and anxiety symptoms compared to women without sexual dysfunction. For both men and women, sexual dysfunctions were associated with diabetes distress.